Edgar Vincent Clark, CCC-S

Speech-Language Pathologist · Vidalia, GA

Individual Active NPI

NPI number 1962611202

Practice location

101 Harris Industrial Blvd
Vidalia, GA 30474-8845
Phone
(912) 537-2044
Fax
(912) 277-2098

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NPI record

NPI
1962611202
Entity type
Individual (Type 1)
Enumeration date
May 22, 2007
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Speech-Language Pathologist Primary 235Z00000X SLP004577 GA

Mailing address

PO Box 383
Glenwood, GA 30428-0383
Phone
(912) 568-7687

About Edgar Clark

Edgar Vincent Clark, CCC-S is a healthcare provider registered in the NPI registry with the primary taxonomy Speech-Language Pathologist (code 235Z00000X). The practice location is 101 Harris Industrial Blvd, Vidalia, GA 30474-8845. The NPI number 1962611202 was assigned on May 22, 2007 and the record was last updated on July 8, 2007.

Edgar Clark lists a license in the registry: #SLP004577 (GA) for Speech-Language Pathologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Edgar Vincent Clark, CCC-S?

The NPI number is 1962611202.

What is the phone number of Edgar Clark?

The phone number listed for the practice location is (912) 537-2044.

Where is Edgar Clark located?

101 Harris Industrial Blvd, Vidalia, GA 30474-8845.

What is the taxonomy code for Edgar Clark?

The primary taxonomy code is 235Z00000X – Speech-Language Pathologist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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